PROJECT SUMMARY
Sexual concerns are among the most common, distressing, and persistent aspects of life after cancer. For at
least half of breast and gynecological cancer survivors, cancer treatment adversely affects physical, social, or
psychological aspects of sexual health. Examples include vaginal pain, loss of sensation, poor body image,
disrupted intimate relationships, and loss of sexual interest. Despite this, sexual concerns are often
unaddressed, with one major reason being lack of access to evidence-based interventions. In short, to improve
sexual health in cancer survivorship, there is an urgent need to test and implement accessible, evidence-based
interventions that can effectively reach cancer survivors in need. Mindfulness-based interventions have
demonstrated efficacy in addressing a range of sexual concerns and improving psychosexual health outcomes.
Our preliminary research demonstrated support for the acceptability of a virtually delivered mindfulness-based
intervention adapted specifically for breast and gynecological cancer survivors experiencing sexual concerns.
However, a more rigorous evaluation of this promising intervention, called Mindful After Cancer (MAC), is
needed to support wide implementation and dissemination. A pragmatic trial would be ideal because it would
facilitate the evaluation of MAC in the context of routine practice, which leads to more generalizable results and
shortens the gap from research to implementation outside of the trial setting, thus more quickly increasing
access for cancer survivors in need. The Specific Aims of the proposed R34 are 1) To conduct a pilot trial in
preparation for a future multisite pragmatic trial of the virtual MAC intervention and 2) To identify contextual
factors that may shape equitable reach and future implementation of the intervention. Our feasibility objectives
are to develop protocols for 1) recruitment, 2) retention, and 3) training and supervision for adequate
intervention fidelity for the planned future trial. Results of the proposed pilot trial will provide a robust scientific
foundation and preparation for a rigorously designed multisite pragmatic trial. Evaluation of intervention access
barriers and strategies to improve equitable recruitment and reach in both academic- and community-based
care settings will inform future implementation and dissemination of mindfulness-based interventions such as
MAC. Overall, results of the proposed project will readily translate to the protocol for rigorous, well-designed
multisite pragmatic trial to evaluate the effectiveness of the virtual MAC intervention in real world conditions
where we expect to implement and disseminate the intervention.